Diagnostic accuracy of urinary antigen tests for legionellosis : A systematic review and meta-analysis

Copyright © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved..

BACKGROUND: Urinary antigen tests (UATs) have been used for the early detection of legionellosis and have demonstrated moderate sensitivity and high specificity. However, the most recent systematic review and meta-analysis published in 2009 evaluated the accuracy of UATs; since then, UAT accuracy may have changed owing to advances and developments in UAT technology and epidemiological changes in the frequency of Legionella species that cause legionellosis. Therefore, this systematic review and meta-analysis aimed to update the accuracy of UATs for legionellosis among patients with suspected pneumonia.

METHODS: Overall, 1326 studies were screened, 21 of which fulfilled the eligibility criteria for quality assessment and meta-analysis. Data from 5772 patients, including 1368 (23.7%) with the target condition (i.e., suspected legionellosis), were included in the analysis. The overall quality of the included studies, which was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, was unclear.

RESULTS: The calculated pooled sensitivity and specificity were 0.79 (95% confidence interval [CI], 0.71-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. Subpopulation analysis revealed that the accuracy of UATs for sensitivity and specificity for Legionella pneumophilia serogroup 1 was 0.86 (95% CI, 0.78-0.91) and 1.00 (95% CI, 0.99-1.00), respectively.

CONCLUSIONS: This study demonstrated that the sensitivity and specificity of UATs were moderate and high, respectively, which is comparable to the results reported in 2009. Therefore, UATs may be a useful method for the early detection of legionellosis caused by Legionella pneumophila serogroup 1.

CLINICAL TRIAL REGISTRATION: The review protocol was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041080).

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:60

Enthalten in:

Respiratory investigation - 60(2022), 2 vom: 28. März, Seite 205-214

Sprache:

Englisch

Beteiligte Personen:

Kawasaki, Takeshi [VerfasserIn]
Nakagawa, Natsuki [VerfasserIn]
Murata, Maki [VerfasserIn]
Yasuo, Shunsuke [VerfasserIn]
Yoshida, Takuo [VerfasserIn]
Ando, Koichi [VerfasserIn]
Okamori, Satoshi [VerfasserIn]
Okada, Yohei [VerfasserIn]
Japanese ARDS Clinical Practice Guideline Systematic Review Task Force [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Legionella
Legionellosis
Meta-Analysis
Pneumonia
Review
Systematic Review
Systematic review and meta-analysis
Urinary antigen test

Anmerkungen:

Date Completed 16.02.2022

Date Revised 16.02.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.resinv.2021.11.011

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM335081657